By Nadia Koblosh
The Orthodox elderly, like all senior citizens, and the people who care for them when they become ill or infirm, find they need guidance in knowing what medical and health care services they may be eligible to receive. Senior citizen groups in the community often invite speakers to their meetings to talk on health care subjects.
The local parish is another place that can be helpful to the elderly by providing opportunities for programs, speakers and videos to help answer common questions of a medical, financial or legal nature. When such programs are sponsored in the parish, seniors often feel freer to talk about the given subject and ask questions as they are in more familiar and trusted surroundings.
Parishes can invite in professional people from agencies in the community. They can also call on their own parishioners - doctors, nurses, chiropractors, lawyers, financial planners, etc. to share their knowledge and point people in the right direction for help. Such sharing is a valuable lay ministry.
As a registered nurse who works in home health care, I’ve had questions from many families regarding health services. The following are a sampling:
My mother lives in a distant city and I’m concerned because she needs treatment for sores on both legs. Is there any way I can arrange for some help to be sure she is doing it correctly?
Your mother will probably be eligible for home care services through Medicare. The criteria for service would be:
1) that she is homebound (which means she does not go out regularly by herself. She may be taken to the hairdresser, doctor’s office, etc. by someone else, but it is a taxing effort for her to leave her home.) that she requires a skilled service which would be performed by a nurse, registered physical therapist or speech therapist. Occupational therapy and social worker visits can also be provided along with skilled visits.
You should contact a Medicare certified home care agency in your area to do an evaluation visit. This information is listed in your local phone directory under Home Health Services. They will contact her MD and make the home visit. They will then make her (or you) aware of what her needs are and if she qualifies for service under Medicare. You may want to have several agencies do an evaluation visit as some are more knowledgeable concerning what Medicare will allow and will be willing to provide it. This visit is usually a no charge visit.
2) If your mother is found to qualify, I would recommend visits by the social worker also to determine her long range needs and assist her in applying for local or state supported services that would begin after Medicare services terminate. A review of financial income is required in order to receive these additional services. Once it is established that she does qualify, the services would be on-going and could include non-skilled help such as help with bathing, dressing, fixing meals etc. (Each state has different guidelines.)
3) My parents are elderly and there is no one living near them to help with household needs. They could also use some help with their personal care. Are they eligible for home care?
If there is no skilled need, they may still qualify for home health aid or chore services provided through a local or state program. Again, contact a Medicare certified home care agency in the area and they should provide you with the information needed to begin the evaluation process by the appropriate agency. It may also be possible to get assistance for people under the age of 65 for these same services if they are disabled.
“My father was told by the home care agency that he did not qualify for Medicare home care services. From the information provided, I feel he does. How can I pursue this further?”
You can contact Medicare directly to get a determination. If you are still dissatisfied, you should contact LAMP (Legal Aid for Medicare Patients). There is no charge for this service and the phone number is 1-800-321-5267.
“What are some conditions that would qualify patients for home care services under Medicare and how many hours a week can be provided?”
Persons who require Vitamin B12 injections (due to pernicious anemia or malabsorbtion syndrome) or other injections, indwelling catheters which require regular changing of same, patients recently discharged from the hospital who require instruction and monitoring, stroke victims or persons with crippling diseases who could benefit from physical therapy or speech therapy, newly diagnosed diabetics or those new to insulin administration or blood sugar monitoring, etc.
As to hours of service provided, Medicare has a 35 hour rule which provides up to 5 hours per day of combined nurse and home health aid services. This is based strictly on need and can be adjusted according to the case. In extreme emergencies the 56 hour, 21 day rule may apply which provides 8 hours per day for nurse and home health aid combined. Both can have additional services of the physical therapist, speech therapist, occupational therapist and social worker.
“My father is dying from a terminal illness and we do not want to place him in a hospital or nursing home. Can we get some help for him in our home?”
Yes. Contact a Medicare certified home hospice agency and they will inform you of what is available to assist you in caring fr your father at home. They can provide skilled services beyond the regular Medicare allowances and have a volunteer network to assist with respite care needs.
Should you have a question in the area of home health services to which you have not been able to find an answer, I’d be glad to assist you.
Nadia Koblosh, an RN, works for a home health agency in Bristol, CT. She attends Christ the Saviour Mission in Southbury, Ct where she is the choir director.